The use of digoxin should be reassessed concludes a new analysis showing patients with atrial fibrillation on digoxin are at a significantly increased risk of death.
The six-year analysis of 4,060 patients with atrial fibrillation from the AFFIRM trial found patients on digoxin were 41% more likely to die from any cause, compared with patients not taking the drug.
Patients taking digoxin also had a 35% increased risk of cardiovascular mortality, a statistically significant difference compared with patients not on digoxin.
In both patients with and without heart failure digoxin significantly increased the risk of all-cause mortality, compared with patients not taking the drug, with a 37% increased risk in patients without heart failure and 41% in patients with heart failure.
The US researchers found no significant associations between the effect of digoxin and gender for all-cause or cardiovascular mortality.
The researchers concluded: ‘Our study underscores the importance of reassessing the role of digoxin in the management of AF in patients with or without heart failure.’
European Heart Journal 2012, available online 27 November